Kornimate/medical-research-clean huggingface dataset:
evaluation of hemodynamic effects of cascade hemofiltration in septic shock

Conditions: Sepsis

Summary: septic shock is a major cause of mortality and morbidity in critically ill patients. septic shock is associated with an overwhelming, systemic overflow of pro inflammatory and anti-inflammatory mediators, which leads to generalized endothelial damage, multiple organ failure, and altered cellular immunological responsiveness. although our understanding of the complex pathophysiological alterations that occur in septic shock has increased greatly as a result of recent clinical and preclinical studies, mortality associated with the disorder remains unacceptably high, ranging from 30% to 50%. to date, attempts to improve survival with innovative, predominantly anti-inflammatory therapeutic strategies have been disappointing. a standard hemofiltration rate of 35 ml/kg/hour has been successfully used to treat acute renal failure. however, this dose does not alter plasma levels of inflammatory mediators, suggesting that its ability to clear these mediators is suboptimal. higher doses of hemofiltration (up to 120 ml/kg per hour) have been demonstrated to improve cardiac function and hemodynamics in several animal models of sepsis. high-volume hemofiltration (hvhf) was thus conceived and applied in patients with septic shock, showing an improvements in hemodynamics with decreased vasopressor requirements and improved survival in patients admitted after a cardiac arrest. the main benefit described with high volume hemofiltration is a hemodynamic improvement (e.g reduction in catecholamines' requirement). this improvement seems to be due to the removal of a badly defined network of middle molecular weight peptides. to remove efficiently these middle molecular peptides, a high filtration rate is needed. however, with high filtration rates, there is also a high clearance for smaller molecules, including antibiotics, electrolytes, vitamins, trace elements and amino acids. the cascade hemofiltration system has been designed for a more efficient removal of middle molecular weight peptides with a limited solute consumption. the goal of this study is the evaluation of the hemodynamic improvement using cascade hemofiltration in patients treated for septic shock.


Eligibility criteria:
inclusion criteria: * patient with a septic shock diagnosed by the medical staff team. * patient mechanically ventilated and treated by high doses of catecholamines after adequate fluid administration (≥ 1.0 mg/h of norepinephrine or epinephrine) for ≥ 120 minutes and \< 24h. exclusion criteria: * age (years) \ 85. * weight \>120 kg * thrombocytopenia 50\< g/l or neutrophils \<0.5 giga/l * contra indication to heparin anticoagulation. * patient requiring catecholamines (epinephrine ≥ 1 mg/h or norepinephrine ≥ 1 mg/h) for \>24h. * patient admitted to the icu ≥ 7 days before the inclusion criteria. * comorbid conditions with an expected survival \< 6 months * inclusion (\<28 days) in another study interfering with the goals of the current investigation. * pregnancy * immune compromised patients (e.g. being treated for cancer, treated by immunosuppressors or steroids, aids).
a study of intensity-modulated pleural radiation therapy (imprint) in people with thymic cancer that has spread to the lining of the lungs and chest

Conditions: Thymic Malignancies; Pleural Metastases

Summary: the researchers are doing this study to find out whether hemithoracic intensity-modulated pleural radiation therapy (imprint) is a safe treatment that causes few or mild side effects in people with pleural metastases from thymic malignancies. the researchers will also look at whether hemithoracic imprint is effective against participants' cancer.


Eligibility criteria:
inclusion criteria: * provide written informed consent to participate on the study * patients must have a pathologically confirmed diagnosis of thymic malignancy. thymic carcinoma is allowed. * patients must have radiologic or pathologic evidence of pleural metastases. patients may have de novo stage iva or recurrent disease in the pleura. gross disease in the fissure is allowed if resected. * no evidence of extrathoracic metastatic disease or contralateral pleural/pericardial disease. * patient age ≥ 18 years but ≤ 80 years at the time of consent * karnofsky performance status ≥ 80% * preoperative or postoperative pulmonary function tests: dlco \> 40% predicted (corrected for hgb) and fev1 ≥ 35% (corrected for hgb) * glomerular filtration rate (gfr): ≥50 ml/min/1.73 m2 (must be calculated using estimated creatinine clearance (crcl) by the cockcroft-gault (c-g) equation (nephron 1976;16:31-41): crcl (ml/min) = \[140 - age (years)\] x weight (kg) \[x 0.85 for female patients\] 72 x serum creatinine (mg / dl) ° in cases of concern about decreased renal function and potential high radiation dose to the kidneys, an optional nuclear medicine kidney function scan may be performed prior to radiation therapy to determine the functional contribution of each kidney. exclusion criteria: * continuous oxygen use * patients with an acute flare of myasthenia gravis requiring addition of new medication in the past 6 months * prior nephrectomy on the contralateral side of the pleural metastases * prior thoracic radiation therapy preventing hemithoracic pleural imrt. prior thymic bed radiation is allowed. prior pleural sbrt is allowed. * patients undergoing extrapleural pneumonectomy. other surgical resection approaches of the pleural nodules (ex: p/d, debulking/metastasectomy) are allowed. surgical resection of the primary thymic tumor is allowed. * acute congestive heart failure requiring hospitalization within the past 30 days. * copd requiring chronic oral steroid therapy of \> 10 mg prednisone daily or equivalent at the time of registration. inhaled corticosteroids are allowed * unstable angina requiring hospitalization and/or transmural myocardial infarction within the last 3 months * history of interstitial lung disease * pregnant or lactating women * men or women not using effective contraception

Keywords: intensity-modulated pleural radiation therapy (imprint) 22-098
discovering factors in head and neck cancer patients' clinical study experiences

Conditions: Head and Neck Cancer

Summary: enrollment in clinical trials usually favors a particular demographic group. but there is limited research available to explain what study attributes affect the completion of these specific demographic groups. this trial will evaluate the safety and efficacy of head and neck cancer treatments. the focus will be on tracking the rates of completion and withdrawal among these individuals. it will also try to analyze data from the perspective of different demographic groups to check for recurring trends which might yield insights for the sake of future head and neck cancer studies.


Eligibility criteria:
inclusion criteria: * patient is at least 18 years of age * patient is able and willing to comply with the treatment/follow-up schedule and requirements * patient must provide written informed consent exclusion criteria: * participants who are vulnerable to any intervention * women who are pregnant, intend to become pregnant, or are lactating * inability to perform regular electronic reporting

Keywords: head and neck cancer
study assessing the safety and therapeutic effect of buprenorphine in mdd patients

Conditions: Depression

Summary: the primary objective of this study is to assess the therapeutic effect of buprenorphine in mdd population. the secondary objectives of this study are to assess the therapeutic effect, the feasibility and safety of buprenorphine in a mdd population.


Eligibility criteria:
inclusion criteria: * outpatients and inpatients * men and women 18-68 years of age. * primary dsm-iv diagnosis of major depression, single or recurrent episode confirmed by the structured clinical interview for the dsm-iv (scid-iv), with the additional requirements of a current episode ≥4 weeks and cgi-s ≥4. * total hdrs-21 ≥20 and item 1 score ≥2 at the screening visit. * the patient did not respond to at least one antidepressant medication given for an accepted dose and duration. * if currently taking benzodiazepines, the patient must be clinically appropriate to discontinue treatment with those agents, and able to tolerate no benzodiazepines during the study period. * capable and willing to provide informed consent * able to adhere to the treatment schedule. exclusion criteria: * depression secondary to a general medical condition. * history of substance abuse or dependence within the past 6 month (except nicotine and caffeine). * all antidepressant medications, must have been in stable dosage for at least 6 weeks prior to entry into the study, with no anticipation of change over the duration of the study. * use of any medication(s) listed on the excluded medication list within the time that mansion for each medication on the list. * any psychotic disorder (lifetime), including schizoaffective disorder, or major depression with psychotic features • bipolar disorder • eating disorder * presence (within 12 months of baseline) of a personality disorder (such as antisocial, schizotypal, histrionic, borderline, narcissistic) as assessed by the investigator to be primary, causing a higher degree of distress or impairment than mdd. * use of a monoamine oxidase inhibitor (maoi) within 2 weeks of the screening visit * use of a cyp3a4 inhibitors and cyp3a4 inducers within 2 weeks of screening visit. * present suicidal risk as assessed by the investigator or significant suicide risk based on hdrs-21 item 3 score of 3 or 4 or a history of attempted suicide in the last 6 month * known or suspected pregnancy * women who are breast-feeding * women of childbearing potential and not using a medically accepted form of contraception when engaging in sexual intercourse. * patients with severe respiratory insufficiency or asthma - anticipation require examination of pulmonologist. * patients with severe hepatic or renal insufficiency. * patients with history of head injury, increased intracranial pressure, hypotension, prostatic hypertrophy or urethral stenosis- anticipation require examination of neurologist.
use of a metronome in cardiopulmonary resuscitation: a simulation study

Conditions: Cardiac Arrest

Summary: the purpose of this study is to determine if the use of a metronome improves chest compression rate and depth during cardiopulmonary resuscitation (cpr) on a pediatric manikin.

the study will be conducted in the simulation laboratory at miami children's hospital. chest compressions will be performed on a compression pediatric simulator. it will consist of two main groups randomly assigned to chest compressions without an audible metronome and chest compressions with audible metronomic tones that beep 100 times per minute for chest compressions. the metronome will be used to coach the correct rate. the same people will complete both arms of the study at one visit. specifically, the participants will do 2 minutes of chest compressions followed by a 15-minute break then another 2 minutes of chest compressions (to avoid fatigue) with an acceptable range for rate 90-110 bpm and depth of 38-51mm. the subjects will be informed about the metronome, but will not be informed about the measured variables, such as rate and depth of chest compressions. however, the participants will be reminded at the beginning of their visit about the pals card, i.e. appropriate rate and depth. the use of "talking people noise" from youtube will be played in the background to fully model a cardiac arrest scenario (to see if participants ignore the metronome) and will be used during each group session. a noise dosimeter will be used to ensure this noise level is the same for each scenario. the manikin's airway will be secured with an endotracheal tube with continuous ventilations so chest compressions can be continued without interruption. recommendations for chest compression rate and depth are per pediatric advanced life support (pals) according to the 2010 american heart association (aha) guidelines. data will be collected via the manikin which will wirelessly transmit the data (chest compression rate and depth) to a computer. the manikin has cpr sensing and recording technology software built in. this software records sternum movement depth and rate of chest compressions. criteria for adequate cpr quality are defined as compression rate between 90-110 per minute and compression depth between 38-51mm.

Eligibility criteria:
inclusion criteria: * health professionals with a minimum of basic life support training according to the 2010 aha guidelines capable of performing chest compressions.

Keywords: cardiopulmonary resuscitation pediatric simulation study metronome
daily disposable dispensing clinical trial of test lens against stenfilcon a lens

Conditions: Myopia

Summary: the purpose of this study is to investigate the overall clinical performance of the test daily disposable stenfilcon a lens with solution additive (test) compared to the stenfilcon a lens (control).

this will be, prospective, multicenter, double-masked, randomized, bilateral, 1 month cross-over, dispensing study comparing the test lens against the stenfilcon a control lens with a study duration of approximately two months. each subject will be randomized to wear either the test or control as a matched pair first and subjects will be randomized based on the order in which the subject is enrolled and qualified into the study.

Eligibility criteria:
inclusion criteria: * a person is eligible for inclusion in the study if he/she: * has had a self-reported oculo-visual examination in the last two years. * is at least 18 years of age and has full legal capacity to volunteer. * has read and understood the information consent letter. * is willing and able to follow instructions and maintain the appointment schedule. * is correctable to a visual acuity of 20/40 or better (in each eye) with their habitual vision correction or 20/20 best-corrected. * must achieve 20/30 or better (in each eye) with study lenses * requires spectacle lens powers between -0.75 and -6.50 diopters sphere (0.25d steps). * has no more than 0.75 diopters of refractive astigmatism. * currently wears soft contact lenses. * have clear corneas and no active ocular disease. * has not worn lenses for at least 12 hours before the examination exclusion criteria: * a person will be excluded from the study if he/she: * has never worn contact lenses before. * has any systemic disease affecting ocular health. * is using any systemic or topical medications that will affect ocular health. * has any ocular pathology or severe insufficiency of lacrimal secretion (moderate to severe dry eyes) that would affect the wearing of contact lenses. * has persistent, clinically significant corneal or conjunctival staining using sodium fluorescein dye. * has any clinically significant lid or conjunctival abnormalities, active neovascularization or any central corneal scars. * is aphakic. * has undergone corneal refractive surgery. * is pregnant, lactating, or planning a pregnancy at the time of enrolment (by verbal confirmation at the screening visit). * have taken part in any other contact lens or care solution clinical trial or research, within one week prior to starting this study.
an epidemiological study of subjects with immune thrombocytopenic purpura to evaluate the relationship between platelet counts, endogenous thrombopoietin levels, endogenous anti-thrombopoietin antibodies, and selected autoimmune markers

Conditions: Purpura, Thrombocytopenic, Idiopathic; Immune Thrombocytopenic Purpura

Summary: this study involves the collection of blood samples from patients with immune thrombocytopenic purpura (itp) to evaluate the relationship between platelet counts, blood levels of a hormone called thrombopoietin that controls platelet production by the bone marrow, and blood levels of antibodies against thrombopoietin that could interfere with the action of this hormone. blood samples will also be stored if separately agreed to by the patient for analysis of genes that might affect platelet production. at a single outpatient clinic visit, patients will have a medical history taken, and blood samples drawn for testing. results from this study may help further understand the control of platelet production in patients with itp, and suggest new therapeutic approaches.

this study involves the collection of blood samples from patients with immune thrombocytopenic purpura (itp) to evaluate the relationship between platelet counts, blood levels of a hormone called thrombopoietin that controls platelet production by the bone marrow, and blood levels of antibodies against thrombopoietin that could interfere with the action of this hormone. blood samples will also be stored if separately agreed to by the patient for analysis of genes that might affect platelet production. at a single outpatient clinic visit, patients will have a medical history taken, and blood samples drawn for testing. results from this study may help further understand the control of platelet production in patients with itp, and suggest new therapeutic approaches.

Eligibility criteria:
diagnosis of itp, based on the history, physical examination, complete blood count, and examination of the peripheral smear, which should exclude other causes of thrombocytopenia. these criteria for itp are based on the american society of hematology practice guideline for itp. subjects 5 years of age or older. before the study specific procedure, the subject or legally acceptable representative must give written informed consent(s) for participation in the study. no subjects with documented history of human immunodeficiency virus (hiv) or hepatitis. no subjects with known underlying causes of thrombocytopenia such as lupus erythematosus, autoimmune thyroid disorders, drug-induced thrombocytopenia, bone marrow disorders, and liver disease. no psychiatric or addictive disorders that compromise the subject's ability to give truly informed consent for participation in the study.

Keywords: bleeding cytokines immune response pharmacogenomic serum antibodies itp immune thrombocytopenia purpura
an investigational drug study in patients with type 2 diabetes mellitus (0431-024)

Conditions: Diabetes Mellitus, Type 2

Summary: the purpose of this investigational study is to determine the safety and effectiveness of an investigational drug in patients with type 2 diabetes mellitus (a specific type of diabetes).

the duration of treatment is 104 weeks.

Eligibility criteria:
inclusion criteria: * patients who are at least 18 years of age and not older than 78 with type 2 diabetes mellitus
the effect of the ovarian reserve on the recurrent pregnancy loss

Conditions: Ovarian Reserve; Miscarriage, Recurrent

Summary: the purpose of this study is to determine whether ovarian reserve is related to recurrent pregnancy loss

this study will be conducted at the gynecology and infertility department of kanuni sultan süleyman training and research hospital from 2016 to 2017. the approval of the local institutional review board (kaek/2016.22.31) was obtained in june 2016 and informed consents of all subjects have been prepared. rm is defined as three or more pregnancy losses at \<20 weeks of gestation or fetal weight \<500 g. women with history of rm for whom routine workup for rm (chromosomal analyses of both partners; levels of prolactin and tsh; anticardiolipin antibody, lupus anticoagulant, antinuclear antibody, and coagulation studies; and pelvic ultrasonography) is negative are assigned to the rm group. the control group consists of healthy women with no history of rm who are seeking contraception in the center's family planning unit. to keep the power of the study at 80% with an alpha-level of 0.05, a sample size of minumum 60 patients in each group was required. demographic data (age,gravidity,parity,pregnancy loss,bmı) ovarian reserve parameters(amh,fsh,lh,e2,afc) will be recorded and then two groups will be compared. data will be analyzed with the use of medcalc version 16.4.8 by gökhan yıldırım. mean,median,sd,lowest and highest frequency ,and ratio values are used at statistical complementary of data .quantitative data will be analyzed with the use of the student t test and the mann-whitney u test. a chisquare test will be used for analyses of qualitative data

Eligibility criteria:
inclusion criteria: * women with rm between 20-40 years old exclusion criteria: * anovulation or pcos * presence of endometrosis by laparoscopy or ultrasonography * history of ovarian surgery * tobacco use * systemic chemotherapy * pelvic irradition * genetic abnormalities * irregular menstruel cycle * family history of premature ovarian failure

Keywords: ovarian reserve, pregnancy loss
sarcopenia and visceral obesity in esophageal and gastric cancer

Conditions: Esophageal Cancer; Gastric Cancer; Sarcopenia; Sarcopenic Obesity; Obesity; Visceral Obesity; Quality of Life; Surgery; Complication of Treatment; Chemotherapeutic Toxicity; Physical Activity; Oncology

Summary: in line with improvements in oncologic outcome for patients with esophageal cancer, the attritional impact of curative treatment with respect to functional status and health-related quality of life (hr-ql) in survivorship is increasingly an important focus. functional recovery after surgery for esophageal cancer is commonly confounded by anorexia and early satiety, which may reduce oral nutrient intake with consequent malnutrition and weight loss. one in three disease-free patients has more than fifteen percent body weight loss at three years after esophagectomy. the espen special interest group on cachexia-anorexia in chronic wasting diseases has defined sarcopenia as skeletal muscle index (smi) of ≤39 cm2/m2 for women and ≤55cm2/m2 for men, while similar cut-off points have been validated in upper gastrointestinal and respiratory malignancies (less than 38.5 cm2/m2 for women and 52.4 cm2/m2 for men). the european working group on sarcopenia in older people (ewgsop) additionally recommends that assessment should also include determination of muscle function, for example gait speed or grip strength, where possible. the presence of sarcopenia is associated with increase treatment-associated morbidity, impaired hr-ql, reduced physical and role functioning, and increased pain scores in older adults. in addition, a previous longitudinal study demonstrated that the decline in hr-ql over a six year period in older adults was accelerated in the presence of sarcopenia. as such, sarcopenia may represent a modifiable barrier to recovery and subsequent retention of hr-ql and functional status, and may reinforce a persistent illness identity, among patients following potentially curative treatment for esophageal cancer.


Eligibility criteria:
inclusion criteria: * initial staging computed tomography (ct) scan capturing the level of the l3 conducted at our centre and available for review exclusion criteria: * patients who had a history of previous gastrointestinal resection, other active malignancy, eating disorder, inflammatory bowel disease or other significant illness that might alter body composition were excluded from analysis.